A Systematic Review of Obesity Disparities Research

Context A review of interventions addressing obesity disparities could reveal gaps in the literature and provide guidance on future research, particularly for populations with a high prevalence of obesity and obesity-related cardiometabolic risk. Evidence acquisition A systematic review of clinical trials in obesity disparities research that were published in 2011–2016 in PubMed/MEDLINE resulted in 328 peer-reviewed articles. Articles were excluded if they had no BMI, weight, or body composition measure as primary outcome or were foreign ( n =201); were epidemiologic or secondary data analyses of clinical trials ( n =12); design or protocol papers ( n =54); systematic reviews ( n =3); or retracted or duplicates ( n =9). Forty-nine published trials were summarized and supplemented with a review of ongoing obesity disparities grants being funded by the National, Heart, Lung and Blood Institute. Evidence synthesis Of the 49 peer-reviewed trials, 27 targeted adults and 22 children only or parent–child dyads (5 of 22). Interventions were individually focused; mostly in single settings (e.g., school or community); of short duration (mostly ≤12 months); and primarily used behavioral modification (e.g., self-monitoring) strategies. Many of the trials had small sample sizes and moderate to high attrition rates. A meta-analysis of 13 adult trials obtained a pooled intervention effect of BMI –1.31 (95% CI=–2.11, –0.52, p =0.0012). Institutional review identified 140 ongoing obesity-related health disparities grants, but only 19% ( n =27) were clinical trials. Conclusions The reviews call for cardiovascular-related obesity disparities research that is long term and includes population research, and multilevel, policy, and environmental, or "whole of community," interventions.